For the calendar year 2023 reporting period, eligible hospitals and Critical Access Hospitals (CAHs) were required to use 2015 Edition Cures Update certified electronic health record technology (CEHRT) to meet the Medicare Promoting Interoperability Program requirements.  CAHs may apply for a Hardship Exception if complying with this requirement results in significant hardship.  CAHs may submit their application electronically  or contact the Center for Clinical Standards and Quality Service Center (CCSQ) Service Center at (866) 288-8912 to complete a verbal application.

Last week, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Outpatient Hospital Prospective Payment System (OPPS) Final Rule for Calendar Year 2025.  In addition to annual updates in outpatient hospital Medicare payment rates, this rule finalizes new standards for hospitals and Critical Access Hospitals (CAHs) with obstetric (OB) units regarding maternal quality assessment and performance improvement, the organization, staffing, and delivery of OB care, and staff training on evidence-based maternal health practices.  For hospitals and CAHs with emergency services, it adds standards on facility readiness in caring for emergency services’ patients, including pregnant, birthing, and postpartum women. The rule also finalizes new transfer policies for hospitals that mirror the current CAH and Rural Emergency Hospital standards. These Conditions of Participation (CoPs) will be phased in over two years.

Effective January 1, 2025.  On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which updates the Medicare payment policies and rates for home health agencies (HHAs). CMS projects an increase in aggregate payments by 0.5 percent, and also finalizes a permanent prospective adjustment of -1.975% to the CY 2025 home health payment rate. CMS finalized a new standard for acceptance to service policy in the Home Health Conditions of Participation (HH CoPs) and their proposal with modification to require ongoing respiratory illness reporting for Long-Term Care (LTC) facilities. The rule is effective January 1, 2025.

Among key findings from the University of Minnesota Rural Health Research Center:

• Rural counties have a higher proportion of people with medical debt in collections than urban counties, and this difference is associated with lower average household incomes.
• The county-level median amount of medical debt in collections held by rural residents is higher compared to their urban counterparts, even after accounting for income differences.
• The proportion of people with and amount of medical debt in collections are both higher in rural and urban communities of color than in rural and urban communities overall.

A new report evaluates programs at the U.S. Department of Health & Human Services (HHS) and finds that uninsured rates among adults under age 65 in rural areas have fallen substantially since the passage of the Affordable Care Act (ACA), from 23.8 percent in 2010 to 12.6 percent in 2023.  Uninsured rates among rural residents are much higher in states that have not yet expanded Medicaid, and analysts acknowledge ongoing disparities in health outcomes between rural and urban areas.  Research has shown, for instance, disparities in maternal outcomes, behavioral and mental health outcomes, risk factors for chronic disease such as obesity, hypertension, and cardiovascular disease as well as in potentially harmful health behaviors such as smoking and physical inactivity, to name a few.

The Department of Health and Human Services (HHS) released new data showing that nearly 1.5 million people with Medicare Part D saved nearly $1 billion in out-of-pocket prescription drugs costs in the first half of 2024 because of the Biden-Harris Administration’s Inflation Reduction Act. Thanks to the Inflation Reduction Act, some people with high drug costs have their out-of-pocket drug costs capped at around $3,500 in 2024. Next year that cap lowers to $2,000 for everyone with Medicare Part D. The report shows that if the $2,000 cap had been in effect this year, 4.6 million enrollees would have hit the cap by June 30 and would not have to pay any more out-of-pocket costs for the rest of the year. Learn more here.

The president-elect campaigned on promises to shake up public health institutions, reshape federal health programs, and slash high costs across the system. Trump has said he’s ready for campaign lieutenants like Robert F. Kennedy Jr. to “go wild” on health, medicine, and food policy. Read more.

The CDC Advisory Committee on Immunization Practices issued a recommendation for people 65 years and older and those who are moderately or severely immunocompromised to receive a second dose of 2024-2025 COVID-19 vaccine six months after their first dose. See the announcement on CDC’s Newsroom website. CDC’s upcoming Clinician Outreach and Communication Activity call also relates to respiratory virus. The upcoming call, 2024-2025 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Providers, is Thursday, Nov. 14 from 2:00-3:00 pm. Join the day of the session. **CE credits available** Visit the call webpage for call-in info and more details.

In January 2024, the commonwealth launched PA Navigate, a new website that connects residents to community organizations, government agencies and health care providers for access to resources for basic needs, such as food, housing, and childcare. Read more In efforts to educate the community, a PA Navigate flyer was developed if you’d like to share within your community.